Stevens intends to close District General Hospitals!

Ealing residents demanding that all four local District General Hospitals be kept open
Ealing residents demanding that all four local District General Hospitals be kept open

SIMON Stevens, the Chief Executive of NHS England, has announced his plan for closing major District General Hospitals in England and replacing them with small local private community hospitals linked to networks of GPs.

Stevens said that he wanted more elderly patients cared for ‘in the community’ in small local hospitals.

Stevens likened his new model to those provided in the United States. As the former deputy director of the biggest American health corporation and health insurer, UnitedHealth, he has personal knowledge of the way the private American health maintenance organisations (HMOs) work.

He said that he is not suggesting a return of 1950’s style cottage hospitals. Nor is he saying that no hospital will close. His announcement means that the policy of running down and closing 60 District General Hospitals adopted in 2006, and pushed forward by Lord Darzi and David Nicholson under Labour, will continue.

However, rather than just closing the facilities of the smaller DGHs, some will be converted to what Stevens called new community hospitals. He wants a relaxing of the European Working Time Directive regulations for medical staff, so that their working hours can be extended.

This ties in with the drive by NHS England to change the contracts of all medical staff enabling seven-day working at basic rates of pay.

He praised the closer working of health and social care services in Sweden, which implies a support for current suggestions of the King’s Fund and other government advisers for the merging of the health and social care budgets. This latter would bring with it the the introduction of means testing healthcare.

He spoke in support of more midwife-led care in maternity services. This is in line with The National institute of Clinical Excellence’s (NICE’s) recent recommendations to encourage more midwife-led care in stand alone units and at home, in place of mothers giving birth in hospitals.

Stevens intends to replace District General Hospitals with Health Maintenance Organisation (HMO) type, vertically integrated, local hospitals amenable to the health insurance industry. These would provide managed care for health insurance, self-funded health care benefit plans, as in the USA.

The plan is for HMO’s to use the facilities released by the continued rundown and closure of District General Hospitals and the traditional cottage hospitals.

It would bring US-style health care for sale to the UK.